Oncology Extended Care Clinic Reduced Urgent Cancer-Related ED Visits

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The gradual shift of oncologic care to the ambulatory setting can overwhelm cancer care clinics and lead to ED visits.
The gradual shift of oncologic care to the ambulatory setting can overwhelm cancer care clinics and lead to ED visits.
The following article features coverage from the 2018 Oncology Nursing Society's Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor's conference coverage. 

WASHINGTON, DC — Oncology extended care clinics (OECCs) may lessen the burden of cancer clinics that are over capacity, allowing patients with cancer to receive appropriate urgent cancer-focused care, according to an oral presentation at the 2018 Oncology Nursing Society (ONS) Annual Congress.

Regular oncologic care has been shifting more and more to the ambulatory setting, increasing urgent cancer care needs and overwhelming cancer care clinics. As a result, patients often report to the emergency department (ED) with symptoms that could be treated in the ambulatory setting, leading to unnecessary ED utilization and suboptimal treatment for this high-need population. An urgent visit pilot program at the Smilow Cancer Hospital revealed a dire need for an OECC. 

For this study, Maureen Raucci, MS, RN, and associates analyzed 1105 patient visits between April 3rd, 2017, and September 23rd, 2017, to the OECC. The maximum occupancy of the OECC is 6 patients with 2 beds and 4 chairs, and is staffed with a multidisciplinary team of advanced care practitioners, registered nurses, and patient care associates. Patients could only be seen by appointment after primary oncology provider referral and an OECC staff triage determined appropriateness. 

Results showed that of the 1105 patient visits, 70% were discharged and 30% were admitted, a dramatic improvement from the 90% admittance rate reported in the pilot study.  

The volume of patient visits was consistent daily except for Sundays, and the highest volume of visits occurred between 11 amand 7 pm. 

Raucci concluded that “we have realized a 12% decrease in ED visits. […] The overall patient experience has been exceptional as assessed through patient reports and Press Ganey scores. The advent of the OECC has shown to be a value-added service to the oncology care at Smilow.”

Reference

Raucci M, Dest V. To admit or not to admit: does an oncology extended care clinic impact hospital admissions?Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.


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